Nursing Commons^™

St. Cloud Hospital Nursing Director Orientation And Mentorship Program, Deb Eisenstadt, Tiffany Omann-Bidinger, Diane Pelant

Nursing Posters

Develop and implement an evidence-based orientation and mentorship program for nursing directors using AONE’s Nursing Executive Competencies along with a structure curriculum.

Reducing The Second Victim Phenomenon: Healing Our Healers With Caritas Coaching, Shanda N. Whittle

DNP Qualifying Manuscripts

Background: The second victim phenomenon is one in which nurses and other healthcare providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol to cope with serious mistakes in the absence of a healthier means for healing (Wu, 2000). This phenomenon can lead to healthcare professional absenteeism, leaving the job or leaving the profession altogether (Burlison, Quillivan, Scott, Johnson, & Hoffman, 2018). Following the release of an editorial by Dr. Wu (2000), organizational peer support programs have been developed to reduce this phenomenon. These types of peer support programs have been found to counter absenteeism and …

Nursing Leaders’ Ethical Decision-Making About Professional Boundaries And Nurse-Patient Relationships: A Mixed Methods Explanatory Sequential Design, Pamela Scott

Theses & Dissertations

The purpose of this mixed methods explanatory sequential design study was to ascertain nursing leaders’ knowledge and skill in ethical decision-making when evaluating and managing professional nurse-patient relationship boundaries. It was also the purpose of this study to better understand nursing leaders’ perception of moral, cognitive, and organizational factors influencing their ethical decision-making in evaluating and managing professional nurse-patient relationships, with the intent of generating a theory grounded in the views of the participants as a final outcome of the study. The two theories, virtue ethics and self-efficacy comprise the ethicality construct of the conceptual framework explaining the nurse leaders’ …

Evidence Based Solutions: Creating Specialty Units, Jacqueline Adams, Msn, Rn, Corln, Ccctm, Megan Bagonis, Rn, Bsn, Michelle Lewandowski, Rn, Bsn, Mha

Department of Nursing Posters

Purpose

To describe how the development of a specialty Ear, Nose, and Throat (ENT) care unit staffed by experienced ENT nurses positively influences quality outcomes, patient experience, ICU admissions, and readmission and LOS rates in a large, urban, academic medical center.

Reflection Of Distinct Nursing Leadership In Argentina, Indonesia And Jamaica., Emely Baez

Senior Honors Projects

Nurses provide more than 80% of patient care worldwide. Unfortunately, this percentage does not correlate with the number of nurses involved in leadership roles. It’s discouraging to think that the decisions on health care, community, patient care and policy are not being made by those who provide these services and often are the patients’ most passionate advocates. This discrepancy in leadership led me to investigate what factors are at play. Through my observations of nursing practice and leadership in the countries of Jamaica, Argentina and Indonesia, I have specified some of the obstacles or lack of resources in place that …

Resilience And Coping In Mothers Of Children With Sickle Cell Disease, Holly Carter

Dissertations

Sickle cell disease (SCD) is a prominent chronic illness in the United States. The Centers for Disease Control and Prevention (2016) estimated that one child out of every 365 African-American births will have SCD, affecting approximately 100,000 Americans. Supporting and promoting the integrity of the family and its’ members when a child has SCD is important for each family member’s well-being. Specific family characteristics, such as resilience and coping are important to understand because they can mitigate stress and create positive family outcomes (Brown et al., 1993; Cousino & Hazen, 2013; Hildenbrand, Barakat, Alderfer, & Marsac, 2015; O’Hanlon, Camic, & …

Attitudes Of New Graduate Rns Regarding Their Readiness For Practice Before And After Hospital Orientation, Diane Young

Dissertations

The acuity level of patients continues to increase making it more vital than ever that new graduate Registered Nurses (RNs) be prepared to give safe, quality care when leaving their hospital’s orientation program (Spector et al., 2015). Today, new graduate RNs need orientation programs that will ensure a smooth transition into nursing practice. This involves the ability to apply higher-level knowledge and skills in everyday practice situations, thereby, maintaining quality care (Henderson, Ossenberg, & Tyler, 2015).

The purpose of this study was to identify differences between new graduate RNs’ opinions on readiness for practice, as measured by the Casey-Fink Readiness …

Mississippi Registered Nurse Perceptions When Communicating With Limited-English-Speaking And Non-English-Speaking Patients, Mary Pipper Widdig

Dissertations

Communication serves as the foundation for safe and effective healthcare practice. Effective nurse-patient communication is the cornerstone of the nurse-patient relationship and is vital for the delivery of safe and effective healthcare. Research has shown patients who are communication impaired are at a greater risk of medical error and poorer health outcomes. A review of the literature revealed various nurse perceptions of barriers when providing care for limited-English-speaking patients and non-English-speaking patients. LEP and NEP patients also identified similar perceived barriers when receiving care. Both nurses and patients revealed a distrust for interpreters and interpreter services. The literature review revealed …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Improving Diabetic Foot Exams And Education In A Primary Care Clinic, Haley Duff

The Eleanor Mann School of Nursing DNP Capstone Projects

Diabetes is one of the most common chronic diseases worldwide. The persistent nature of the disease increases the risk of complications, including blindness, kidney failure, lower limb amputation, and cardiovascular disorders. In the United States, there were a total of 7.2 million hospital discharges in 2014, with diabetes as the diagnosis. It was estimated that 108,000 of those discharges were for a lower-extremity amputation (Centers for Disease Control and Prevention [CDC], 2017). The American Diabetes Association recommends that all adults with diabetes should undergo a comprehensive foot evaluation at least annually, and daily foot care education should be provided. Preventive …

Nursing Interventions That Address Barriers In The United States That Impact Neonatal Mortality, Victoria D. Sullivan, Ashton J. White

Anna Vaughn School of Nursing Undergraduate Work

In 2016, four out of every 1000 babies born in the US died within one month of age. This systematic research review explored nursing interventions that addressed barriers that impact neonatal mortality. The most significant barriers nurses faced in reducing and preventing NM were maternal access to healthcare and education during pregnancy, which can be influenced by maternal age, low socioeconomic status, lack of familial support, poor health literacy, and geographic location. The articles examined included nursing interventions that were evidence-based and addressed barriers relating to NM. Interventions promoting the reduction of NM included education of women’s health and prenatal …

Managing The Effects Of Poor Sleep Quality In Nurses, Emily Huene, Sarah Rausch, Georgia Vasiu, Hannah Lopez, Rachael Valentz, Msn, Rn, Ccrn

Anna Vaughn School of Nursing Undergraduate Work

Staffing shortages, high turnover rates, and prolonged work shifts has caused decreased sleep quality in nurses due to fatigue. The fatigued nurse causes concern for safety, coordination and agility, patient avoidance, lack of compassion, impaired cognitive function, risk for chronic diseases, and patient care errors. This systematic research review was designed to identify evidence-based practice nursing interventions currently being used to manage the effects of reduced sleep quality. Methods for performing this systematic research review were to search multiple databases using keywords, scanning article titles and abstracts, and critiquing for relevance and quality. Findings from this systematic review found multiple …

The Impact Of A School-Based Program On Diabetes And Cardiovascular Risk Factors, Lindsey Thielman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obesity is an increasing health issue both in the United States and worldwide. Furthermore, childhood obesity is increasing in prevalence. Childhood obesity is associated with an increased risk of comorbidities in adulthood. Obesity in childhood and adolescence makes one more likely to become obese during adulthood. This study sought to determine the effect of a school-based obesity prevention program on diabetes and cardiovascular risk factors such as body mass index (BMI), blood pressure, waist circumference, and acanthosis nigricans. Measurements were taken before education in the fall semester, and again after two education sessions in the spring semester. Student and faculty …

Implementing An Early Progressive Mobility Protocol In The Intensive Care Unit, Jennifer Mattone

The Eleanor Mann School of Nursing DNP Capstone Projects

Background: More people are requiring intensive care unit stays for their illnesses due to the complexity of individuals care needs. Many patients remain in bed during their hospital stay due to the severity of their illness, resulting in increased time spent on the ventilator and increased length of stay in the intensive care unit (ICU). There are many risks to of being bed bound, including decreased muscle mass, development of pressure ulcers, increased hospital stay and increased time on the ventilator. All of these factors drive up hospital costs for the hospital and the consumer. Purpose of Project: The purpose …

Inpatient Diabetes Education To Improve Disease Knowledge, Jennifer Miles

The Eleanor Mann School of Nursing DNP Capstone Projects

Diabetes is a complex chronic disease currently affecting almost 25 million people in the United States (Ostling et al., 2017; Saccomano, 2014). The prevalence of diabetes is increasing yearly. Diabetes is a common comorbidity associated with hospitalizations and 30-day inpatient readmissions (Ostling et al., 2017; Chang, Kirby, Phelps, Rhee, Meneghine & Gunasekaran, 2017). Some retrospective studies have shown that inpatient diabetes education can reduce the readmission rate by up to 34% in this population (Healy et al., 2013). The Chronic Care Model (CCM) exemplifies the need to move the education to a proactive and preventative approach for further admissions instead …

Risk For Maternal Infant Bonding Reduction In High Risk Deliveries And The Recovery Phases, Amanda M. Karimi, Corie Vanarsdale Msn

Anna Vaughn School of Nursing Undergraduate Work

Bonding is one of the first developmental tasks for infants and is imperative for successful growth. The bonding phase begins in the periods immediately following birth. Complications that inhibit bonding postpartum may delay this process. Breastfeeding barriers, maternal substance abuse, and poor maternal mental health are among the contributing factors to delayed bonding. The purpose of this research study was to answer the question, “What best practiced nursing interventions assist mothers to promote bonding with the newborn after high risk deliveries?” This research review included a sample size of 10 articles which provided a variety of interventions to promote bonding …

To Replace Or Not To Replace? Replacing Short Peripheral Catheters Based On Clinical Indication, Deborah Maier

Masters External Publications

Short peripheral catheters (SPCs) are the most frequently used medical devices in hospital settings. Many hospital policies state that SPCs be replaced at 96 hours, which can be unnecessary and costly. A pre–post quality improvement initiative was implemented following complications surrounding removal of timed SPCcatheters compared with those removed by clinical indication, using the Visual Infusion Phlebitis (VIP) scale. Data collected included patient demographics, SPC characteristics, nursing time, and product use. SPCs replaced based on clinical indication remained intact longer and had fewer complications than those in the group with routinely replaced SPCs. Decreasing SPC replacements by use of clinical …

The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …

Silence In Violence: A Curse Or A Goodwill, Afsheen Hirani, Nasreen Rafiq, Shyrose Sultan, Zainish Hajani, Samreen Siraj

School of Nursing & Midwifery

Healthcare professionals face dilemmas regarding maintaining and breaching confidentiality while dealing with victims of sexual violence. The sensitivity of the cases of violence and the aim to prevent harm generates ambiguity for sound ethical and legal decision making. In Pakistan, maintaining silence is often preferred over breaking the silence. Thus, it is essential to view the risks and benefits of the conflicting positions keeping in mind the diverse perspectives and the bigger picture. Organizations, community and government can plan different strategies to put an end to this obscene game of “silence in violence”.

Advanced Informatics Competencies Of Nurses At Sutter Maternity And Surgery, Jessica Liston

Doctoral Projects

Today, the profession of nursing requires the integration of many sciences and skill sets in order to care for the increasing acute and chronic illness in our patient populations. In order for nurses to safely care for patients in highly technological environments, they must integrate knowledge from Nursing Informatics (NI), to advance the profession, deliver safe high-quality patient care and effective documentation that drives improvement in patient outcomes. When nurses have an understanding of advanced NI skills, they are better equipped to become super users that train and lead teams in optimization of electronic health records (EHRs) to support them …

Effects Of Transport On Oral Temperature Of Post-Surgical Patients Transported From Pacu To Nursing Units, Kathy Dureault, Msn, Rn, Cpan

Articles, Abstracts, and Reports

Introduction: Maintaining normothermia beyond the walls of the PACU is critical for patient stabilization and meeting a predetermined clinical pathway. At one Southern California Community Hospital there were complaints/reports of patients being hypothermic on arrival to the inpatient unit. This was despite the fact that those patients met the criteria of normothermia prior to discharge from PACU. Identification of the problem: There is a gap in the literature on the effect of intra-hospital transport on patient temperature.

Purpose of the Study: The purpose of this descriptive study was to determine changes in oral temperature resulting from transport between the PACU …

Exploring The Homeless Persons Perception Of Living In A Long-Term Care Facility, Janice Woods

Dissertations

Objective:The purpose of this study was to explore the lived experiences of homeless persons admitted to a nursing home facility. Originally, the study was to explore their understanding of and their experience with advance health care planning; coincidently, the participants were more open to their experience of living in a long-term care facility.

Method:A convenience sample of 13 participants (12 male, 1 female) at four long-term care facilities in Southern California were interviewed about their perception of advanced health care planning, including the physician’s orders for life sustaining treatment (POLST); a consent form required in all nursing homes. …

The Use Of Clinical Decision Support To Improve Nursing Practice, Kathleen Klimpel

Dissertations

Healthcare information technology is solidly entrenched in most acute care hospitals but the need to demonstrate its positive impact on patient outcomes persists. Clinical decision support (CDS) is an informatics tool that is highly customizable to promote patient improvement activities. Despite its high potential, studies have had mixed results regarding the impact of CDS and it has not been widely studied in the realm of nursing practice. One aim of this dissertation was to analyze the concept of CDS in order to inform the examination of the relationships between CDS implementation and nursing interventions. The determining factors of nurses use …

Introducing The Clinically Aligned Pain Assessment, Penny Mclain, Theresa Nelson, Mary Waldo

Articles, Abstracts, and Reports

Introduction: The Clinically Aligned Pain Assessment (CAPA) is an innovative way of assessing pain by engaging patients in a brief conversation about their comfort, change in comfort, pain control, functionality, and sleep.

Identification of the Problem: According to the Joint Commission (TJC) and the American Society for Pain Management Nursing (ASPMN) the use of the commonly used numeric rating scale (NRS) can lead to opioid overdose and ineffective treatment.

Purpose of the Study: To compare post-surgical patients’ perceptions of the effectiveness of two pain assessment tools, CAPA and NRS.

Methodology: An IRB approved, prospective observational study was conducted. Patients undergoing …

Home Care Instruction For Eye Surgery – Using Health Literacy Best Practices, Jennifer Reynolds

Articles, Abstracts, and Reports

Background Information: Health literacy is a well-established best practice that nurses can use to provide home care instructions post hospital stay. It is an excellent place to start, especially given the intensity of care, complexity of medications and importance of patient adherence. Nurses provide extensive information in a condensed period of time about how to take acre at home. With the anxiety of surgery, potential side effects of anesthesia and the time limitations of an outpatient setting, there is greater risk for patients being unprepared when they leave our care. Patients report this as an overwhelming experience, sometimes with little …

Reducing Re-Hospitalizations Of Patients With Heart Failure At A Skilled Nursing Facility, Louis D'Onofrio Jr.

The Eleanor Mann School of Nursing DNP Capstone Projects

The purpose of this project was to introduce the quality improvement (QI) process to reduce re-hospitalization rates in a skilled nursing facility (SNF) in Stratford, Connecticut for patients having a diagnosis of heart failure (HF). After reviewing the data from the nursing facility for re-hospitalization rates over a three-month period, it was discovered that 22% of patients at the SNF were re-hospitalized within 30 days. Of this population of patients, 22.9% had a diagnosis or complication of HF, which is associated with the highest re-hospitalization rates. This QI project focused on HF education customized towards nursing and nursing assistant staff …

Educational Program For The Management Of Low Back Pain, Amanda Johnson

The Eleanor Mann School of Nursing DNP Capstone Projects

Low back pain is one of the most common reasons that patients seek care from their primary care provider as well as the number one cause of disability worldwide. While low back pain is a prevalent condition that is seen in primary care, the outcomes of treatment continue to remain poor. Facilitating effective care for patients with pain is a major public health concern. Clinical practice guidelines are published but it often takes time for the recommendations to be translated into practice. Dissemination of information is needed. An educational program was created for providers within the Mercy Hospital Rogers system. …

Clinical Pathway For Treating Chronic Knee Pain After Total Knee Arthroplasty, Allen T. Thomas

The Eleanor Mann School of Nursing DNP Capstone Projects

The focus of this DNP project was to develop a clinical pathway for treating patients who suffer from chronic knee pain after knee replacement by creating a standardized documentation template. Currently, there are four teams comprised of four physicians and four mid-level providers who treat patients in the clinical setting. Through review of literature, it was determined that laboratory tests ESR, CRP, and synovial fluid assay; physical knee exam, and radiographic imagine are the three necessary components needed to work-up and diagnose patients with this problem. Gap analysis through chart review showed inconsistency between teams with documenting specifically with the …

Improving Hbpc Utilization, Janet Freeman

The Eleanor Mann School of Nursing DNP Capstone Projects

Home Based Primary Care (HBPC) services in the Central Arkansas Veterans Healthcare System (CAVHS) are underutilized among high-needs, high-risk (HNHR) patients based on baseline assessment of provider capacity. It is important to evaluate this problem as these patients have the highest need for frequent care yet face the most difficult challenges in accessing care. The purpose of this project was to analyze the factors that contribute to the under-utilization of HBPC services in the CAVHS and make recommendations for improvement. An assessment of the CAVHS HBPC service was completed using the Dartmouth Institute Microsystem Academy Outpatient Specialty Care Workbook. Microsystem …

The Effect Of The Coaching Program In Health Behaviors Modification On Hba1c Of Persons With Pre-Diabetes(ผลของโปรแกรมการสอนแนะในการปรับเปลี่ยนพฤติกรรมสุขภาพต่อระดับน้ำตาลเฉลี่ยสะสมในเลือดของผู้ที่มีภาวะก่อนเป็นเบาหวาน), Jintipa Sirikunwiwat, Rungrawee Navicharern

Journal of Nursing Research, Innovation, and Health

Purpose: To study the effect of the coaching program in health behaviors modification of persons with pre-diabetes.Design: Quasi-experimental researchMethods: The subjects were 60 persons with prediabetes in out-patient clinic, Medicine Department of Phrachomklao hospital, Phetchaburi province. Thirty persons with prediabetes per group were matched by sex, age and use of Metformin. The control group received the normal nursing care whereas the experimental group received the coaching program in health behaviors modification. The research instrument were the coaching program in health behaviors modification based on the concept of Haas (1992), The data were collected by demographic data, HbA1C level and health …